This product is designed to pierce your own ear or someone else's ear. Each ear piercing stud is set in a cartridge that is sterilized and can't be touched by your hand. Any product that pierces the skin is required by the AMA (AMERICAN MEDICAL ASSOCIATION) to be sterilized. Wearing gloves is not considered sterilization. Your hands cannot be sterilized. Any product that only touches the skin should be sanitized. The cartridge does not require an ear piercing instrument (used in malls). Instructions are included on the package, but the basic procedure is to squeeze your thumb and fore finger together to pierce the ear. The process is silent and very effective. The studs/styles used to pierce the ear are made out of 14 ct. white gold. 14 ct. gold has the minimum requirement to pierce the ear. The 14 ct. means that 14 parts of the earring is made of pure gold (in this case white gold) and 10 parts of the earring is made of nickel. An example: 10 ct. gold is 10 parts pure gold and 14 parts nickel. 18 ct. gold is 18 parts pure gold and 6 parts nickel. They will always add to 24, hence the cost difference. Nickel is an alloy (Copper, iron, etc. are other examples) that is used to harden pure gold and metals. This training stud should be worn for 3-4 weeks without removal. At that time it should be replaced with a similar material (no nickel) earring. This replacement earring (can be interchanged) should be worn day and night for the following 4 months. The total healing time for a newly pierced ear is about 5-6 months. Very important, the replacement earrings for the 4 month period should be at least 14 ct. gold or higher. These are lower cost and same as malls RETAIL CHARGE IN MALLS: $65-$85 Additional Details ------------------------------ Product description: This product is designed to pierce your own ear or someone else's ear. Each ear piercing stud is set in a cartridge that is sterilized and can't be touched by your hand. Any product that pierces the skin is required by the AMA (AMERICAN MEDICAL ASSOCIATION) to be sterilized. Wearing gloves is not considered sterilization. Your hands cannot be sterilized. Any product that only touches the skin should be sanitized. The cartridge does not require an ear piercing instrument (used in malls). Instructions are included on the package, but the basic procedure is to squeeze your thumb and fore finger together to pierce the ear. The process is silent and very effective. The studs/styles used to pierce the ear are made out of 14 ct. white gold. 14 ct. gold has the minimum requirement to pierce the ear. The 14 ct. means that 14 parts of the earring is made of pure gold (in this case white gold) and 10 parts of the earring is made of nickel. An example: 10 ct. gold is 10 parts pure gold and 14 parts nickel. 18 ct. gold is 18 parts pure gold and 6 parts nickel. They will always add to 24, hence the cost difference. Nickel is an alloy (Copper, iron, etc. are other examples) that is used to harden pure gold and metals. This training stud should be worn for 3-4 weeks without removal. At that time it should be replaced with a similar material (no nickel) earring. This replacement earring (can be interchanged) should be worn day and night for the following 4 months. The total healing time for a newly pierced ear is about 5-6 months. Very important, the replacement earrings for the 4 month period should be at least 14 ct. gold or higher. These are lower cost and same as malls RETAIL CHARGE IN MALLS: $65-$85